Date ID as HomelessHelp for Date ID as HomelessSelect the date this student was identified as homelessmm/dd/yyyy

Date Student Left the DistrictHelp for Date Student Left the DistrictIf the student left the district, please add the date here--remember this may be information you will enter later in the year using your secure login at www.moisd.org/adminmm/dd/yyyy

Is this student an unaccompanied youth?Help for Is this student an unaccompanied youth?Is this student in the custody of a legal guardian?

Is this a foster care student?Help for Is this a foster care student?You must indicate if this is a student that is in foster care.

If this is a foster care student,in current placement for <6 mo., indicate the date placed into care.Help for If this is a foster care student,in current placement for <6 mo., indicate the date placed into care.You may want to put a reminder in your calendar of the date transportation support will end for this student--notice of the termination of this support should go to the family 30 days prior to ending these services. Remember that effective December 10, 2016 DHHS/Foster Care will be responsible for all transportation of students in Foster Care. Beginning January 1, 2017 we no longer include new foster care students in our homeless count.mm/dd/yyyy

School of OriginHelp for School of OriginWrite in the school attended by this student most recently.

District of ResidenceHelp for District of ResidencePlease enter the school district where the student currently lives.

First day of AttendanceHelp for First day of AttendanceSelect the date this student first attended classes. This may not be the same date student enrolled. Often this will be the first day of the current academic year.mm/dd/yyyy

Enrolled Programs(required)Help for Enrolled ProgramsSelect from any of the programs below. Check any that apply for this student.

General Education0-3 Early on or Home VisitingEarly Childhood Special EdGSRPHead StartAlternative EducationDual EnrollmentGifted & TalentedMigrant EducationSpecial EducationVocational EducationNot enrolled in school programs

Enrolled Program

Nighttime ResidenceHelp for Nighttime ResidenceSelect the primary nighttime residence for this student. Numbers correspond to codes in MSDS collected by CEPI.

Student is attending school that is Title I fundedHelp for Student is attending school that is Title I fundedPlease indicated if the building the student is attending receives Title I funds.

Student receives Title I ServicesHelp for Student receives Title I ServicesDoes this student receive Title I services?

Title Services ReceivedHelp for Title Services ReceivedPlease list all services received by this student that are directly tied to Title I supports, services, programs, or funding.

If not receiving Title I services please explain.Help for If not receiving Title I services please explain.All homeless students are eligible for Title I comparable services even if not in a building that receives Title I funding.

CROSS District Transportation-when student resides outside the district.Help for CROSS District Transportation-when student resides outside the district.Use this section when transportation happens across district lines.

SECT. 9 THE FOLLOWING ITEMS ARE TO ENSURE COMPLIANCE WITH MCKINNEY-VENTO LAW

I have documentaion of services and accommodations provided for this student.

I have informed this family/student of their rights under McKinney-Vento law.
Help for I have informed this family/student of their rights under McKinney-Vento law.http://center.serve.org/nche/downloads/parentbrochure_eng.pdf

This student was included in state assessments, if applicable.

Student has been included in our district's pupil accounting system and is coded as homelessHelp for Student has been included in our district's pupil accounting system and is coded as homelessSelect the most appropriate response. If the student is not age eligible to attend school, yet you have identified an older school age child you would select

My district's Dispute Resolution process was provided to this student/family?Help for My district's Dispute Resolution process was provided to this student/family?Please indicate if you provided your districts DR process to this family/student.

Upload a copy of any placement or service decision letters here along with the Dispute Resolution.
Help for Upload a copy of any placement or service decision letters here along with the Dispute Resolution.Upload these documents for auditing purposes.